title: Neurocognitive development in first episode psychosis 5 years follow-up: associations between illness severity and cognitive course.
abstract: Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity, as measured by relapses and diagnostic subgroups. The study is an extension of previous findings from the TIPS-project, reporting stability over the first two years. Sixty-two FEP patients (53% male, age 28 ± 9 years) were neuropsychologically examined at baseline and at 1, 2, and 5 year follow-ups. The test battery was divided into five indices; Verbal Learning, Executive Function, Impulsivity, Motor Speed, and Working Memory. To investigate the effect of illness severity, the sample was divided in groups based on number of relapses, and diagnostic subgroups, respectively. Impulsivity and Working Memory improved significantly in the first two years, followed by no change over the next three years. Motor Speed decreased significantly from 2 to 5 years. Number of relapses was significantly related to Verbal Learning and Working Memory, showing a small decrease and less improvement, respectively, in patients with two or more episodes. No significant association was found with diagnostic group. Neurocognitive stability as well as change was found in a sample of FEP-patients examined repeatedly over 5 years. Of potential greater importance for understanding how psychotic illnesses progress, is the finding of significant associations between neurocognition and number of relapses but not diagnostic group, indicating that neurocognition is more related to recurring psychotic episodes than to the descriptive diagnosis per se.
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway. helene.barder@medisin.uio.no
authors.forename: Helene Eidsmo
authors.initials: HE
authors.lastname: Barder
authors.forename: Kjetil
authors.initials: K
authors.lastname: Sundet
authors.forename: Bjørn Rishovd
authors.initials: BR
authors.lastname: Rund
authors.forename: Julie
authors.initials: J
authors.lastname: Evensen
authors.forename: Ulrik
authors.initials: U
authors.lastname: Haahr
authors.forename: Wenche
authors.initials: W
authors.lastname: Ten Velden Hegelstad
authors.forename: Inge
authors.initials: I
authors.lastname: Joa
authors.forename: Jan Olav
authors.initials: JO
authors.lastname: Johannessen
authors.forename: Hans
authors.initials: H
authors.lastname: Langeveld
authors.forename: T K
authors.initials: TK
authors.lastname: Larsen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
authors.forename: Jan Ivar
authors.initials: JI
authors.lastname: Røssberg
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
authors.forename: Per
authors.initials: P
authors.lastname: Vaglum
authors.forename: Thomas
authors.initials: T
authors.lastname: McGlashan
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001290:Attitude; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D012720:Severity of Illness Index; D013997:Time Factors; D014706:Verbal Learning; D055815:Young Adult
keywords: Diagnosis; First-episode psychosis; Longitudinal course; Neurocognition; Relapse